Effects of Smoking in Weight Changes

CHAPTER 1
The Problem and Its Setting As of today, smoking is one of the vices that are very common among the youth especially for the males. How the researchers came up with a statement as such can be proven just by observing what is happening around oneself. Before moving on, definition of smoking should first be determined. Smoking is the inhalation of the smoke of burning tobacco encased in cigarettes, pipes, and cigars. Casual smoking is the act of smoking only occasionally, usually in a social situation or to relieve stress. A smoking habit is a physical addiction to tobacco products. Many health experts now regard habitual smoking as a psychological addiction, too, and one with serious health consequences. Based on the description above, it depends on how the person utilizes the said activity. It can be casually which is seldom and may also be used as a relaxation technique. Though it is not as often as habitual smoking, it is not free from the dangers that this activity entails. Habitual smoking, on the other hand, is described as an addiction as said above. When saying addiction, there is an over inclination over something that is, in the case of smoking, dangerous to one’s health. In relation to the research, the researchers are to prove if there is any relation between smoking and weight changes among individuals. Considering the fact that the researchers are among the youth is a significant subject. Through the research, this study may explain what causes the changes and what changes it may be. But first, changes must be present to prove the feasibility of the topic.
Theoretical Framework
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Florence Nightingale’s Theory focused on the Environment Related to the study, the researchers rely on the environment as a factor of the study’s efficacy. If one of the factors is changed, the positive results may also vary. As for the study, the factor emphasized is fresh air. The researchers will be changing it to polluted air, specifically by cigarette smoke. The aim of this study is to prove if there will be weight changes if this factor is affected. [pic]
Roy’s Adaptation Model As for the study, the researchers are to prove if there will be weight changes among the subjects. Based on the theory, a person adapts to changes that occurs around him. If the subjects are to adapt to an environment involving consistent cigarette smoke exposure, the researchers have to find out what adaptation would occur among them. The researchers would only focus on weight changes, either it be gain or loss.

Katharine Kolcaba’s theory of Comfort The theory stated is related to the study as the subjects claim that the activity done is comfortable to them. They claim that this is done when they are under stress and is relieving to them.
Conceptual Framework [pic] According to the diagram, smoking can either cause weight gain or weight loss. The reason behind weight loss is because of TNF-alpha release which is a leptin. This triggers release of free fatty acids that can later lead to weight loss. Another is weight gain which is triggered by continuous exposure to nicotine. This can trigger dopamine release and also fat deposition which leads to weight gain. Another is when the glumerular filtration rate is increased. This is caused by vasoconstriction of afferent arterioles in the nephrons. These then will cause release of renin which converts angiotensin I to angiotensin II. This then releases aldosterone that leads to fluid and salt retention which can be seen as edema. This will cause weight gain.

Statement of the Problem The study aims to determine if there will be weight changes among individuals aging 20-30 if they are involved in habitual smoking. Specifically, it sought to answer the following questions: 1. Will there be weight change if an individual is engaged in habitual smoking?

2. If so, what change will be present, is it weight gain or weight loss?

3. When related with animal models, specifically rats, will the same results can be evident?

Assumption of the Study

The researchers assume that the study will show there is weight changes among the subjects. This change is on weight gain. The researchers assume that this may be caused by nicotine that triggers continuous vasoconstriction secreting epinephrine that leads to aldosterone release which further cause salt and fluid retention. There are individual differences that the researchers assume that may affect the change. If the study is performed well, the researchers assume that it is beneficial to the subjects and those interested in the topic discussed.

Significance of the Study

The study aims to practice proper assessment through accurate measurement of weight and being observant of the results that the results will show.

Through this we will be able to restore health or to prevent occurrence of complications regarding chronic smoking.

The study is significance to nursing students specially on how a nurse or health care practitioner can prevent further complications of smoking, since it discusses weight changes. As a nurse, we can help alleviate the foreseen problem if he is knowledgeable of it and is able to impart this knowledge to others.

knowledgeable on weight changes, such as weight gain or weight loss among smokers will enable nurses and other health professionals to giving the right intervention to others.

If the patient exhibits weight gain, his diet will concentrate on controlling weight gain. If the patient shows weight loss, diet will focus on increasing food intake to establish normal weight.

Scope, Delimitations and Limitations of the Study

The study deals on the assessment on weight changes among smokers whose ages are from 20- 30. Furthermore, it will determine the effectiveness of the assessment of significant weight changes and hyperglycemic episodes in male individuals aged 20-30 who are engaged in habitual smoking. It is designed to identify weight changes in the subject such as weight and weight loss.

Definition of Terms
Based on the discussion of the study, difficult terms are used. For clarification, the following are enumerated:
Aldosterone This is a hormone that increases the reabsorption of sodium and water and the release or secretion of potassium in the kidneys.
Angiotensin, This is a protein, causes blood vessels to constrict, and drives blood pressure up.
Angiotensin Converting Enzyme This is an exopeptidase, is a circulating enzyme that participates in the body’s renin-angiotensin system (RAS), which mediates extracellular volume (i.e. that of the blood plasma, lymph and interstitial fluid), and arterial vasoconstriction
Dopamine is a neurotransmitter occuring in a wide variety of animals, including both vertebrates and invertebrates.
Edema This is known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body.
Epinephrine It is a hormone and neurotransmitter that participates in the “ fight or flight” response of the sympathetic nervous system
Glumerulofiltration Rate This describes the flow rate of filtered fluid through the kidney.
Kidney It is an organ in the body which filters body wastes and excretes it through the urethra.
Neurotransmitters They are endogenous chemicals which relay, amplify and modulate signals between a neuron and another cell.
Nicotine It is an alkaloid found in the nightshade family of plants (Solanaceae) which constitutes approximately 0.6–3.0% of dry weight of tobacco, with biosynthesis taking place in the roots, and accumulating in the leaves.
Renin This also known as angiotensinogenase, is a circumcised enzyme that participates in the body’s renin-angiotensin system (RAS) that mediates extracellular volume and arterial vasoconstriction.
Smoking This is the practice where a substance, most commonly tobacco, is burned and the smoke tasted or inhaled.
Smoking Cessation It refers "to quit smoking," or "withdrawal from nicotine."
Tobacco is an agricultural product processed from the fresh leaves of plants in the genus Nicotiana. It can be consumed, used as an organic pesticide, and in the form of nicotine tartrate it is used in some medicines.
Tobacco Smoking It refers to the practice where tobacco is burned and the vapors either tasted or inhaled. The practice began as early as 5000–3000 BC.
Tolerance This indicates support for practices that prohibit ethnic and religious discrimination. Tumor Necrosis Factor (TNF-α) is a pleiotropic inflammatory cytokine
Vasoconstriction This is the narrowing of the blood vessels resulting from the contraction of the muscular wall of the vessels, particularly the large arteries, arterioles and veins.
Weight of an Object is the Magnitude It refers to the force that must be applied to an object in order to support it (i.e. hold it at rest) in a gravitational field.
Weight loss in the Context of Medicine, Health or Physical Fitness, This is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue.

CHAPTER 2
Related Studies and Literature

Local Literature

Smoking Weight Loss Plan?

It is a sad reality that our culture and society is so youth-oriented. The image of what is considered beautiful is what is exemplified today on the runways: those stick-thin, teenage gazelles with boney arms and legs, whose cheeks look a touch sunken and whose cheekbones are a touch too prominent because of their thinness. It is the template that most women right now are trying so hard to fit in, so much that they would do anything to lose the extra weight that they think they are carrying. Some of these women subscribe to various diets, whether scientifically proven or just fads, while some exert all effort to burn away the extra weight. Some take diet teas and diet pills, and some even go through surgical procedures just to suck the fat out of their bodies. Sadly, there are some women who will not stop at anything to lose weight, who are truly convinced that the only way to be considered beautiful is to fit the size and shape of the ideal image that society holds. Unfortunately, smoking is one of those means that some of those women use to lose weight. Why smoking? It is because smoking is one of the fastest ways out there to lose weight. Smoking accelerates weight loss because it kills the appetite and quickly burns the extra weight off the body’s system. But just as unfortunate is that while smoking deadens the appetite, it also burns away the nutrients that our body needs to be healthy and functioning properly. While we may think that the quick weight loss that smoking brings us is good, in the long run, it is only going to cost us our health. Women who smoke are more prone to developing osteoporosis than women who do not smoke. In addition, women who smoke are also more likely to give birth to premature babies and babies with congenital defects. Smoking may be a quick fix to anyone? weight problem, but in the long run, the detriments that it brings to our health is not really worth it. Regardless of what image society projects, a truly beautiful woman is not just someone who is thin and can fit into size six clothes. A truly beautiful woman has a body that is fit and toned and whose skin glows with health. If you want to lose weight, smoking is not the ticket for you. Rather than smoking, you should try simple exercises. You do not have to go to the gym to get some exercise. You could chose to walk when you need to go to the neighborhood store instead of drive. Also, instead of eating three times a day, you can try eating small, nutritious snacks every two or three hours. In this way, you will not feel hungry at all, and yet your body will remain nourished and actually increase its metabolism.
Foreign Literature Cigarette smoking is the most important risk factor in pulmonary disease. The inhalation of cigarette smoke increases airway resistance, reduces ciliary action, increases mucus production, causes thickening of the alveolar- capillary membrane, and causes bronchial walls to thicken and lose their elasticity. These effects occur on both smokers and non smokers (children and adults) who live with smokers. Habitual smokers usually have great difficulty quitting or reducing their smoking and need much encouragement. Nurses play a key role in presenting accurate information about the negative effects of smoking and to encourage the decision to stop smoking or never to start smoking. The major risk factors that can be affected by a change in health care behaviors include cigarette smoking, hypertension, high blood cholesterol levels, and diabetes mellitus. Cigarette smoking is closely linked with coronary heart disease and sudden death. One hypothesis is that components of cigarette smoke maybe toxic, causing oxidative insult and damage to the endothelial lining of blood vessels. Endothelial dysfunction maybe worsened by cigarette smoke, which is why cessation of smoking by high-risk individuals often is followed within a few years by reduced risk of ischemic heart disease
ForeignStudies
According to David H. Phillips Tobacco is a uniquely dangerous consumer product that is addictive and harmful to human health when used as intended. Tobacco smoking is the greatest single cause of preventable illness and premature death, killing half of all people who continue to smoke for most of their lives. Half of these will die before the age of 69. Thirty per cent of all cancer deaths, including nearly 90% of deaths from lung cancer are caused by smoking. The cancers for which epidemiological studies have established a causal association with tobacco smoking are lung, urinary tract, kidney, oral cavity, sinonasal, nasopharynx, hypopharynx and oropharynx, oesophagus, larynx, pancreas, stomach, liver, colorectal, cervix and myeloid leukaemia. Tobacco smoke contains many thousands of chemicals including a plethora of carcinogens. Many carcinogens undergo metabolic activation in mammalian tissues to reactive intermediates that interact with and modify informational macromolecules, such as DNA, with potentially mutagenic consequences. The exposure of human tissues and organs to these carcinogens, and their metabolic activation therein, is the mechanism by which smoking-related cancer is initiated. Over the past 20 or so years the systemic nature of the exposure of the human body to carcinogens inhaled in tobacco smoke has become apparent. This is evident from the widespread formation of DNA and protein adducts in human tissues, and the detection of tobacco-related carcinogens and their metabolites in various bodily fluids. In a recent article Hecht reviewed the detection of human urinary carcinogen metabolites as biomarkers for investigating the relationship between tobacco smoking and cancer. The current article reviews the literature on smoking-related DNA and protein adducts and their uses in monitoring human exposure to, and assessing cancer risk from, tobacco smoking.

Weight Concerns and Smoking Intensive public health education has led to a decline in cigarette smoking over the past four decades. Increasingly, organizations and institutions are adopting non-smoking policies. Within long-term care (LTC), residents' rights to autonomy and self-determination preclude the enforcement of mandatory non-smoking policies. Epidemiological studies show that cigarette smoking is associated with progressive weight loss. However, although weight loss is an index of poor outcomes and increased mortality in nursing home residents, smoking cessation strategies are excluded from most nutritional and weight management LTC pathways. Our study was designed to examine the relationship between cigarette smoking and body weight of residents admitted to a long-term care facility over a six-month period. Non- smokers were compared with smokers.Cigarette smoking has established effects on body weight. The effects of weight concerns on smoking initiation, maintenance, cessation, and relapse, however, are less clear. This review shows that weight concerns are related to smoking behavior in complex ways that differ depending on the smoking outcome (initiation, cessation, and relapse), gender, and age. Dieting behaviors and general weight concerns appear to be positively related both cross-sectionals and prospectively to smoking in White adolescent females. In adults, weight concerns specific to smoking cessation appear to be higher in current smokers and may have a negative influence on cessation and relapse. General weight concerns, however, do not differ by smoking status, nor do they appear to hinder cessation or promote relapse. Dieting behavior is most prevalent in former smokers, least prevalent in current smokers, and intermediate in never smokers, suggesting that ex-smokers may be dieting to control cessation-related weight gain. Smoking cessation interventions that promote dieting to control weight have not been successful in preventing cessation-related weight gain, nor have they increased smoking cessation rates. Population-based prospective studies are needed to determine the broader significance of weight concerns in relationship to smoking cessation in adults. Efforts to address weight concerns in smoking intervention programs may need to target a small subset of individuals for whom weight control smoking is a significant barrier to cessation.
Synthesis:
Tobacco in itself is an adaptive meaning that it can cause either weight gain or weight loss. Embracing the idea that cigarettes directly cause you to shed pounds is foolhardy. It is more likely that the cigarette displaces food cravings that are caused by emotional issues. Instead of reaching for a bag of chips every time you feel stressed, lonely, frustrated or angry you are simply reaching for a smoke instead. Perhaps the biggest issues to do with weight and cigarette smoking is the fact that most people pack on an average of twenty pounds once they quit. This is a huge deterrent for many people when it comes to making the decision to stop and a huge motivator for young women who start smoking in order to stay svelte. Quitting smoking can cause a huge shift in metabolism once your body realizes that the adaptive tobacco is no longer running the show. Deprived of its favorite addictive substance the body goes into panic mode and starts conserving fat to react to the scarcity of nicotine. It is highly possible that the body perceives cigarettes and the sugar that they contain as a necessary source of food. Another reason for weight gain after quitting cigarettes is purely emotional. Most cigarette smokers have an oral fixation, which is why they always have a cigarette in their mouth. Without having the cigarettes around to take care of this oral fixation, the individual will start to appease their desire to always have something in their mouth by snacking. Many cigarette smokers will also reach for candies which mimic the sugar hit of taking a draw on a cigarette and provide their body with a similar sugary spike in their blood sugar. Unfortunately, there is no one simple magical cure for dealing with the problem of gaining weight after quitting smoking. The key is to stay as active as possible, avoid sweets and avoid emotionally charged or stressful situations that might have you reaching for a cigarette or a snack substitute. Drinking cups of strong black coffee is also supposed to help cut the severity of these kinds of cravings and help you save both your lungs and your waistline. Smokers in long-term care facilities lost weight more rapidly than non-smokers. Similarly, weight was regained more slowly in smokers. Long term care health professionals must be cognizant of the role of smoking in perpetuating weight loss. Interdisciplinary programs that integrate nutritional support and smoking cessation strategies should be an integral component of resident care in LTC facilities that permit smoking. In relation to our study, it shows that there are significant disadvantages of smoking. These could cause major diseases that is life threatening and will cause significant changes in the weight of a person. It is one of the responsibilities of the nurse to provide health teaching for the prevention of smoking. Did you know that smoking is currently the leading cause of death in the United States? According to the United States? National Institutes for Diabetes & Digestive & Kidney Diseases, diseases directly resulting from smoking kill more than 400,000 people in the United States. Smoking also increases the risk of a person getting cancer. And not just cancer of the lungs; smoking is linked to cancer of the cervix, the larynx, the esophagus, the kidneys, the pancreas, even breast cancer.

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Environment

Changes in Normal Environment

Fresh air to Polluted air

Body response

Change in weight

Person

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From clean, fresh air to smoke-polluted air

Homeostatatic Response

Adaptation
(weight change)

Person

Needs met as needed

Comfort as own View

Chronic or Social Smoking

TNF-α

vasoconstriction

epinephrine

aldosterone release

fluid and salt retention

release of free fatty acids

weight loss

nicotine

weight gain

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